Written By: Khalid Garba Mohammed Ph.D.
June 15, 2022
One of the top priority goals of the FIP EquityRx programme is promoting equity in the pharmacy workforce and, of course, equity implies fairness and impartiality. The questions to ask are: Is this equity being reflected in all pharmacy practice settings across the world? Are pharmacists given fair play or equal treatment when it comes to workforce recruitment among other healthcare professionals, for instance, in hospitals? In other words, does the number of available pharmacists in practice settings correspond to the number of pharmacists needed in these facilities, especially in developing countries? Are other healthcare professionals, patients, and caregivers’ behaviors towards pharmacists impartial? Sadly, the answer to some of these questions in some practice settings is “no”, and this can lead to the potential for occupational violence.
Occupational violence is an act perpetrated by a customer receiving services from an establishment. It may involve harassment, physical threat, verbal abuse and/or physical attack directed towards the professional rendering the services (pharmacist in this case).
Thus, occupational violence is a constant threat to healthcare workers, including pharmacists, and is detrimental to their job satisfaction, safety, and social wellbeing. In Nigeria, occupational violence towards pharmacists is common. I remembered during my early career as a hospital pharmacist, just about two years into practice, a colleague medical doctor abused me verbally. The doctor came to the accident and emergency pharmacy unit and made a verbal request for an injectable prescription medicine without a written prescription. I refused the verbal request and demanded a written prescription for record and ethical reasons. Instead of the doctor doing the right thing, she decided to verbally attack me in front of my supporting staff and called me names, but I did not give in. She later reported me to the hospital management team, which immediately summoned a meeting on the matter. I was called upon to defend myself before the team, and I am glad I was proved right at the end of the day. Afterward, I asked myself, if occupational violence like this can happen among ourselves, healthcare team, then what could possibly arise from patients and their relatives towards pharmacists and their supporting staff? My experience made me decide to gather a team of colleagues to investigate occupational violence toward pharmacists in practice settings in Nigeria.
Study participants were recruited via email and social media platforms such as WhatsApp, Facebook, LinkedIn, and Twitter, with inclusion and exclusion criteria clearly explained in the online survey tool.
A total of 263 respondents returned the online questionnaire, with a completion rate of 99.2%. The prevalence of occupational violence was 92.7% (95% CI, 90–96). Violent events occurred among 48.7% of pharmacists with at least six years of experience, and 68.4% of hospital pharmacists. The commonly reported factors associated with the violence include long waiting times in the pharmacy (36.5%) due to few available pharmacists and high numbers of patients, refusal to fulfil a customer’s demands (22.1%) and poor communication (21.7%). Events related to verbal abuse were reported among 95% of the participants. The prevalence of violence was significantly higher among hospital pharmacists, compared with those practising in administration or regulatory departments and in community pharmacies. Similarly, physical aggression was higher among hospital pharmacists.
Recommended strategies to reduce incidences of occupational violence toward pharmacists include improving equity in the workforce for healthcare professionals, and engaging more pharmacists, especially in developing countries where governments are reluctant to employ enough pharmacists despite their availability in the labour markets. Other strategies that can be helpful include improved interprofessional harmony, increase awareness, training pharmacists on how to handle situation like this, and penalties against the perpetrators.